Germany's paid pharmacy services struggle despite €537M in unused funds
Germany's remunerated pharmaceutical services (pDL) program has seen slow uptake, leaving €537 million unused. Despite growing demand for certain services, many pharmacies struggle to offer them profitably. Industry groups are now calling for urgent reforms to make these services sustainable.
Since before 2020, the use of paid pharmaceutical services in German pharmacies has risen sharply. By 2023, demand for assessments like medication reviews (DAT) and adherence therapy (AT) had grown by 20–30%. Factors driving this increase included legal integration into social security laws, financial incentives, digital tools like app-based documentation, and the COVID-19 pandemic, which boosted demand for services such as vaccination advice.
Yet, despite this growth, over half of all pharmacies report losses on hypertension risk assessments, which pay a net €11.20 each. Only around one-third manage to turn a profit. The Freie Apothekerschaft (FA) acknowledges that pharmacies have the expertise to deliver these services but argues that current remuneration often fails to cover costs. Beyond financial hurdles, pharmacies face additional obstacles. Staff shortages, heavy administrative workloads, space constraints, and tensions with other healthcare professionals make it difficult to provide pDL services reliably. The German Pharmacists' Association (DAV) warns that without higher, sustainable funding, these services cannot be maintained nationwide in the long term.
The current pDL system leaves a significant portion of funding unspent while many pharmacies operate at a loss. Policymakers must adjust remuneration and address operational challenges to ensure these services remain viable. Without changes, the program's future—and the benefits it could bring—remain uncertain.
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